Korean J Urogenit Tract Infect Inflamm.  2014 Apr;9(1):53-55. 10.14777/kjutii.2014.9.1.53.

Epidural Abscess on the Lumbosacral Area after Transrectal Ultrasonography Guided Prostate Needle Biopsy

• Lee K
• Cho W

• KMID: 1921578
• DOI: http://doi.org/10.14777/kjutii.2014.9.1.53

Abstract

Transrectal ultrasonography guided prostate needle biopsy (PNB) is a useful tool for diagnosis of prostate cancer when the patient has positive findings, such as elevated prostate specific antigen, or a nodule on a digital rectal exam. Because PNB can be performed through the rectum, infection and hemorrhage are the most frequent complications after PNB. Many physicians have reported on their studies, including antibiotic therapy, for decreasing these complications, and some of these treatment modalities have been applied to patients who have undergone PNB. We report on a case of epidural abscess on the lumbosacral area after PNB.

Keyword

Prostatic neoplasms; Needle biopsy; Infection

MeSH Terms

Biopsy, Needle*
Diagnosis
Epidural Abscess*
Hemorrhage
Humans
Prostate*
Prostate-Specific Antigen
Prostatic Neoplasms
Rectum
Ultrasonography*
Prostate-Specific Antigen

Figure

• 

  Fig. 1. (A) T2-weighted L-spine magnetic resonance image (MRI) showing several abscess formations with well enhancing capsule on anterior epidural space of L2-5, sacrum level and posterior epidural space of sactum level. Epidural abscess, L2-5 and sacrum level. Spondylitis, L4-5 (arrow). (B) Compared to (A), MRI showing slightly the increased extent of epidural abscess and spondylitis. (C) MRI showing the decreased extent of epidural abscess and the improvement of spinal canal narrowing. L4-5 laminectomy state.

Reference

1. Nam RK, Saskin R, Lee Y, Liu Y, Law C, Klotz LH, et al. Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol. 2010; 183:963–8.

2. Wagenlehner FM, van Oostrum E, Tenke P, Tandogdu Z, Çek M, Grabe M, et al. GPIU investigators. Infective complications after prostate biopsy: outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, a prospective multinational multicentre prostate biopsy study. Eur Urol. 2013; 63:521–7.

3. Carignan A, Roussy JF, Lapointe V, Valiquette L, Sabbagh R, Pépin J. Increasing risk of infectious complications after transrectal ultrasound-guided prostate biopsies: time to reassess antimicrobial prophylaxis? Eur Urol. 2012; 62:453–9.

4. Adibi M, Hornberger B, Bhat D, Raj G, Roehrborn CG, Lotan Y. Reduction in hospital admission rates due to post-prostate biopsy infections after augmenting standard antibiotic prophylaxis. J Urol. 2013; 189:535–40.

5. Kehinde EO, Al-Maghrebi M, Sheikh M, Anim JT. Combined ciprofloxacin and amikacin prophylaxis in the prevention of septicemia after transrectal ultrasound guided biopsy of the prostate. J Urol. 2013; 189:911–5.

6. Lorber G, Benenson S, Rosenberg S, Gofrit ON, Pode D. A single dose of 240 mg gentamicin during transrectal prostate biopsy significantly reduces septic complications. Urology. 2013; 82:998–1002.

7. Koc G, Un S, Filiz DN, Akbay K, Yilmaz Y. Does washing the biopsy needle with povidone-iodine have an effect on infection rates after transrectal prostate needle biopsy? Urol Int. 2010; 85:147–51.

8. Lorber G, Duvdevani M, Friedman M, Lavy E, Landau EH, Gofrit ON, et al. Sustained-release antibacterial varnish-coated biopsy needle for reduction of infection rates following prostate biopsy-in vitro model. J Endourol. 2013; 27:277–83.